Pathogenesis of histologic variations of appendiceal mucinous neoplasms. [Review]
Citation: European Journal of Surgical Oncology. 49(5):895-901, 2023 05.PMID: 36863914Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: PathologyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Adenocarcinoma, Mucinous | *Appendiceal Neoplasms | *Hyperthermia, Induced | *Peritoneal Neoplasms | Adenocarcinoma, Mucinous/pa [Pathology] | Appendiceal Neoplasms/pa [Pathology] | Combined Modality Therapy | Cytoreduction Surgical Procedures/ae [Adverse Effects] | Humans | Hyperthermia, Induced/ae [Adverse Effects] | Peritoneal Neoplasms/sc [Secondary] | Peritoneum/pa [Pathology] | Retrospective Studies | Survival Rate | Year: 2023Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:2002-2007ISSN:- 0748-7983
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 36863914 | Available | 36863914 |
Available online from MWHC library: 1995 - present, Available in print through MWHC library:2002-2007
BACKGROUND: In order for peritoneal metastases from a primary appendiceal mucinous neoplasm to occur, the wall of the appendix must perforate to allow mucus with tumor cells access to the peritoneal spaces. With progression the peritoneal metastases show a broad spectrum of tumor biology varying from indolent to aggressive activity.
CONCLUSIONS: The estimated survival of these four histologic subtypes in patients having a complete CRS plus HIPEC is of value to the oncologist managing these patients. A mutations and perforations hypothesis was offered in an attempt to explain the broad spectrum of mucinous appendiceal neoplasms that exist. Inclusion of MACA-Int and MACA-LN as standalone subtypes was thought to be necessary. Copyright © 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
METHODS: The histopathology of peritoneal tumor masses was determined from the clinical material resected at the time of cytoreductive surgery (CRS). All groups of patients were treated by a uniform strategy that involved complete CRS and perioperative intraperitoneal chemotherapy. Overall survival was determined.
RESULTS: From a database of 685 patients, four histologic subtypes were identified and long-term survival determined. Four hundred and fifty patients (66.0%) had low-grade appendiceal mucinous neoplasm (LAMN), 37 patients (5.4%) had mucinous appendiceal adenocarcinoma of intermediate subtype (MACA-Int), 159 patients (23.2%) had mucinous appendiceal adenocarcinoma (MACA), and 39 patients (5.4%) had a mucinous appendiceal adenocarcinoma with positive lymph nodes (MACA-LN). The mean survival of the four groups was 24.5, 14.8, 11.2 and 7.4 years, respectively (p < 0.0001). These four subtypes of mucinous appendiceal neoplasms were shown to have distinct survival estimates.
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